How does nutritional state change during a subacute admission? Findings and implications for practice
Background/Objectives: Nutritional status influences patients’ clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics. Subjects/Methods: A longitudinal study was undertaken with consecutive patients adm...
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| Veröffentlicht in: | European journal of clinical nutrition 2016-05, Vol.70 (5), p.607-612 |
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| container_title | European journal of clinical nutrition |
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| creator | Collins, J Porter, J Truby, H Huggins, C E |
| description | Background/Objectives:
Nutritional status influences patients’ clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics.
Subjects/Methods:
A longitudinal study was undertaken with consecutive patients admitted to subacute care wards during a 3-month period. Participants were recruited under a waiver of consent to reflect the usual demographic. Change in classification (malnourished, at risk of malnutrition, well nourished) of the full Mini Nutritional Assessment (full MNA) between admission and discharge was the primary outcome. Weight (kg), mid-arm and calf circumference (cm) change were secondary outcomes. Hand grip strength (kg) and fat-free mass (kg) (assessed using bioelectrical impedance analysis) were measured for a consenting subgroup.
Results:
Participants (
n
=248, 36.7% male) had a median age of 80 years and a length of stay of 17 days. On admission, 29.1% were classified as malnourished. By discharge, nutritional classification remained stable for 62.0% of participants (
n
=132), declined for 10.3% (
n
=22) and improved for 27.7% (
n
=59, including 52.5% malnourished on admission). Impaired cognition (odds ratio (OR)=0.169,
P
=0.002) and higher full MNA score at admission (OR=0.870,
P
=0.001) reduced odds of improvement in full MNA. There was no change in hand grip strength (
n
=46), but there was a decline in mean fat-free mass (−1.1 kg, 95% confidence interval: −0.1 to −2.2 kg,
P
=0.043,
n
=24).
Conclusions:
Multidisciplinary care supports the nutritional state of most patients admitted to subacute care. Those with cognitive impairments or at risk of malnutrition were less likely to demonstrate improvement and may benefit from more intensive or tailored nutritional care. |
| doi_str_mv | 10.1038/ejcn.2016.2 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1787088297</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A451532912</galeid><sourcerecordid>A451532912</sourcerecordid><originalsourceid>FETCH-LOGICAL-c555t-905048185d582c1add70e4726744b9411c4f48b1d5f128e2af015453a9a50c6f3</originalsourceid><addsrcrecordid>eNp9ksGL1DAUxoMo7rh68i4BQQTt-JImaXuSZXFdYcGLnkMmeZ3J0CZj0iL-96bOqrsySA6BfL_3Je_lI-Q5gzWDun2HexvWHJha8wdkxUSjKqkEPCQr6KSoaoDmjDzJeQ9QxIY_JmdcdTVTSq0IXsfv1EXMNMxT8pOPwQw0T2ZCancmbJG6OfmwpYbmeWPsXATjRp9zQd_TKx9cUTM1wVE_HgZvzWKSaR8TPSRjJ2_xKXnUmyHjs9v9nHy9-vDl8rq6-fzx0-XFTWWllFPVgQTRslY62XLLjHMNoGi4aoTYdIIxK3rRbpiTPeMtctMDk0LWpjMSrOrrc_L66HtI8duMedLloRaHwQSMc9asaRtoW941BX35D7qPcyrNZ82V4C0D4Px_VPFSUgED9ZfamgG1D32cSuPL1fpCSCZr3rHFqzpBbTFgMkMM2PtyfI9fn-DLcjh6e7Lg1Z2CHZph2uU4zL_-4z745gjaFHNO2OtD8qNJPzQDvWRKL5nSS6b0Qr-4ncG8GdH9YX-HqABvj0A-LEnBdGdIJ_x-AsPO0aM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1786560106</pqid></control><display><type>article</type><title>How does nutritional state change during a subacute admission? Findings and implications for practice</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Collins, J ; Porter, J ; Truby, H ; Huggins, C E</creator><creatorcontrib>Collins, J ; Porter, J ; Truby, H ; Huggins, C E</creatorcontrib><description>Background/Objectives:
Nutritional status influences patients’ clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics.
Subjects/Methods:
A longitudinal study was undertaken with consecutive patients admitted to subacute care wards during a 3-month period. Participants were recruited under a waiver of consent to reflect the usual demographic. Change in classification (malnourished, at risk of malnutrition, well nourished) of the full Mini Nutritional Assessment (full MNA) between admission and discharge was the primary outcome. Weight (kg), mid-arm and calf circumference (cm) change were secondary outcomes. Hand grip strength (kg) and fat-free mass (kg) (assessed using bioelectrical impedance analysis) were measured for a consenting subgroup.
Results:
Participants (
n
=248, 36.7% male) had a median age of 80 years and a length of stay of 17 days. On admission, 29.1% were classified as malnourished. By discharge, nutritional classification remained stable for 62.0% of participants (
n
=132), declined for 10.3% (
n
=22) and improved for 27.7% (
n
=59, including 52.5% malnourished on admission). Impaired cognition (odds ratio (OR)=0.169,
P
=0.002) and higher full MNA score at admission (OR=0.870,
P
=0.001) reduced odds of improvement in full MNA. There was no change in hand grip strength (
n
=46), but there was a decline in mean fat-free mass (−1.1 kg, 95% confidence interval: −0.1 to −2.2 kg,
P
=0.043,
n
=24).
Conclusions:
Multidisciplinary care supports the nutritional state of most patients admitted to subacute care. Those with cognitive impairments or at risk of malnutrition were less likely to demonstrate improvement and may benefit from more intensive or tailored nutritional care.</description><identifier>ISSN: 0954-3007</identifier><identifier>EISSN: 1476-5640</identifier><identifier>DOI: 10.1038/ejcn.2016.2</identifier><identifier>PMID: 26931666</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/700/1518 ; 692/700/228/491 ; 692/700/2814 ; Aged ; Aged, 80 and over ; Arm ; Bioelectricity ; Classification ; Clinical Nutrition ; Cognition ; Cognitive ability ; Confidence intervals ; Electric Impedance ; Epidemiology ; Fat-free body mass ; Female ; Geriatric Assessment ; Grip strength ; Hand Strength ; Hospitalization ; Humans ; Impedance ; Internal Medicine ; Longitudinal Studies ; Male ; Malnutrition ; Malnutrition - diagnosis ; Malnutrition - etiology ; Malnutrition - physiopathology ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Nutrition ; Nutrition Assessment ; Nutritional Status ; original-article ; Patient admissions ; Patients ; Product/Service Evaluations ; Public Health ; Risk Factors ; Subacute care ; Subacute Care - statistics & numerical data ; Subgroups</subject><ispartof>European journal of clinical nutrition, 2016-05, Vol.70 (5), p.607-612</ispartof><rights>Macmillan Publishers Limited 2016</rights><rights>COPYRIGHT 2016 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group May 2016</rights><rights>Macmillan Publishers Limited 2016.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c555t-905048185d582c1add70e4726744b9411c4f48b1d5f128e2af015453a9a50c6f3</citedby><cites>FETCH-LOGICAL-c555t-905048185d582c1add70e4726744b9411c4f48b1d5f128e2af015453a9a50c6f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26931666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Collins, J</creatorcontrib><creatorcontrib>Porter, J</creatorcontrib><creatorcontrib>Truby, H</creatorcontrib><creatorcontrib>Huggins, C E</creatorcontrib><title>How does nutritional state change during a subacute admission? Findings and implications for practice</title><title>European journal of clinical nutrition</title><addtitle>Eur J Clin Nutr</addtitle><addtitle>Eur J Clin Nutr</addtitle><description>Background/Objectives:
Nutritional status influences patients’ clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics.
Subjects/Methods:
A longitudinal study was undertaken with consecutive patients admitted to subacute care wards during a 3-month period. Participants were recruited under a waiver of consent to reflect the usual demographic. Change in classification (malnourished, at risk of malnutrition, well nourished) of the full Mini Nutritional Assessment (full MNA) between admission and discharge was the primary outcome. Weight (kg), mid-arm and calf circumference (cm) change were secondary outcomes. Hand grip strength (kg) and fat-free mass (kg) (assessed using bioelectrical impedance analysis) were measured for a consenting subgroup.
Results:
Participants (
n
=248, 36.7% male) had a median age of 80 years and a length of stay of 17 days. On admission, 29.1% were classified as malnourished. By discharge, nutritional classification remained stable for 62.0% of participants (
n
=132), declined for 10.3% (
n
=22) and improved for 27.7% (
n
=59, including 52.5% malnourished on admission). Impaired cognition (odds ratio (OR)=0.169,
P
=0.002) and higher full MNA score at admission (OR=0.870,
P
=0.001) reduced odds of improvement in full MNA. There was no change in hand grip strength (
n
=46), but there was a decline in mean fat-free mass (−1.1 kg, 95% confidence interval: −0.1 to −2.2 kg,
P
=0.043,
n
=24).
Conclusions:
Multidisciplinary care supports the nutritional state of most patients admitted to subacute care. Those with cognitive impairments or at risk of malnutrition were less likely to demonstrate improvement and may benefit from more intensive or tailored nutritional care.</description><subject>692/700/1518</subject><subject>692/700/228/491</subject><subject>692/700/2814</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arm</subject><subject>Bioelectricity</subject><subject>Classification</subject><subject>Clinical Nutrition</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>Confidence intervals</subject><subject>Electric Impedance</subject><subject>Epidemiology</subject><subject>Fat-free body mass</subject><subject>Female</subject><subject>Geriatric Assessment</subject><subject>Grip strength</subject><subject>Hand Strength</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Impedance</subject><subject>Internal Medicine</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Malnutrition - diagnosis</subject><subject>Malnutrition - etiology</subject><subject>Malnutrition - physiopathology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Nutrition</subject><subject>Nutrition Assessment</subject><subject>Nutritional Status</subject><subject>original-article</subject><subject>Patient admissions</subject><subject>Patients</subject><subject>Product/Service Evaluations</subject><subject>Public Health</subject><subject>Risk Factors</subject><subject>Subacute care</subject><subject>Subacute Care - statistics & numerical data</subject><subject>Subgroups</subject><issn>0954-3007</issn><issn>1476-5640</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ksGL1DAUxoMo7rh68i4BQQTt-JImaXuSZXFdYcGLnkMmeZ3J0CZj0iL-96bOqrsySA6BfL_3Je_lI-Q5gzWDun2HexvWHJha8wdkxUSjKqkEPCQr6KSoaoDmjDzJeQ9QxIY_JmdcdTVTSq0IXsfv1EXMNMxT8pOPwQw0T2ZCancmbJG6OfmwpYbmeWPsXATjRp9zQd_TKx9cUTM1wVE_HgZvzWKSaR8TPSRjJ2_xKXnUmyHjs9v9nHy9-vDl8rq6-fzx0-XFTWWllFPVgQTRslY62XLLjHMNoGi4aoTYdIIxK3rRbpiTPeMtctMDk0LWpjMSrOrrc_L66HtI8duMedLloRaHwQSMc9asaRtoW941BX35D7qPcyrNZ82V4C0D4Px_VPFSUgED9ZfamgG1D32cSuPL1fpCSCZr3rHFqzpBbTFgMkMM2PtyfI9fn-DLcjh6e7Lg1Z2CHZph2uU4zL_-4z745gjaFHNO2OtD8qNJPzQDvWRKL5nSS6b0Qr-4ncG8GdH9YX-HqABvj0A-LEnBdGdIJ_x-AsPO0aM</recordid><startdate>20160501</startdate><enddate>20160501</enddate><creator>Collins, J</creator><creator>Porter, J</creator><creator>Truby, H</creator><creator>Huggins, C E</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160501</creationdate><title>How does nutritional state change during a subacute admission? Findings and implications for practice</title><author>Collins, J ; Porter, J ; Truby, H ; Huggins, C E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c555t-905048185d582c1add70e4726744b9411c4f48b1d5f128e2af015453a9a50c6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>692/700/1518</topic><topic>692/700/228/491</topic><topic>692/700/2814</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arm</topic><topic>Bioelectricity</topic><topic>Classification</topic><topic>Clinical Nutrition</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>Confidence intervals</topic><topic>Electric Impedance</topic><topic>Epidemiology</topic><topic>Fat-free body mass</topic><topic>Female</topic><topic>Geriatric Assessment</topic><topic>Grip strength</topic><topic>Hand Strength</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Impedance</topic><topic>Internal Medicine</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Malnutrition</topic><topic>Malnutrition - diagnosis</topic><topic>Malnutrition - etiology</topic><topic>Malnutrition - physiopathology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Nutrition</topic><topic>Nutrition Assessment</topic><topic>Nutritional Status</topic><topic>original-article</topic><topic>Patient admissions</topic><topic>Patients</topic><topic>Product/Service Evaluations</topic><topic>Public Health</topic><topic>Risk Factors</topic><topic>Subacute care</topic><topic>Subacute Care - statistics & numerical data</topic><topic>Subgroups</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Collins, J</creatorcontrib><creatorcontrib>Porter, J</creatorcontrib><creatorcontrib>Truby, H</creatorcontrib><creatorcontrib>Huggins, C E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of clinical nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Collins, J</au><au>Porter, J</au><au>Truby, H</au><au>Huggins, C E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How does nutritional state change during a subacute admission? Findings and implications for practice</atitle><jtitle>European journal of clinical nutrition</jtitle><stitle>Eur J Clin Nutr</stitle><addtitle>Eur J Clin Nutr</addtitle><date>2016-05-01</date><risdate>2016</risdate><volume>70</volume><issue>5</issue><spage>607</spage><epage>612</epage><pages>607-612</pages><issn>0954-3007</issn><eissn>1476-5640</eissn><abstract>Background/Objectives:
Nutritional status influences patients’ clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics.
Subjects/Methods:
A longitudinal study was undertaken with consecutive patients admitted to subacute care wards during a 3-month period. Participants were recruited under a waiver of consent to reflect the usual demographic. Change in classification (malnourished, at risk of malnutrition, well nourished) of the full Mini Nutritional Assessment (full MNA) between admission and discharge was the primary outcome. Weight (kg), mid-arm and calf circumference (cm) change were secondary outcomes. Hand grip strength (kg) and fat-free mass (kg) (assessed using bioelectrical impedance analysis) were measured for a consenting subgroup.
Results:
Participants (
n
=248, 36.7% male) had a median age of 80 years and a length of stay of 17 days. On admission, 29.1% were classified as malnourished. By discharge, nutritional classification remained stable for 62.0% of participants (
n
=132), declined for 10.3% (
n
=22) and improved for 27.7% (
n
=59, including 52.5% malnourished on admission). Impaired cognition (odds ratio (OR)=0.169,
P
=0.002) and higher full MNA score at admission (OR=0.870,
P
=0.001) reduced odds of improvement in full MNA. There was no change in hand grip strength (
n
=46), but there was a decline in mean fat-free mass (−1.1 kg, 95% confidence interval: −0.1 to −2.2 kg,
P
=0.043,
n
=24).
Conclusions:
Multidisciplinary care supports the nutritional state of most patients admitted to subacute care. Those with cognitive impairments or at risk of malnutrition were less likely to demonstrate improvement and may benefit from more intensive or tailored nutritional care.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>26931666</pmid><doi>10.1038/ejcn.2016.2</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | European journal of clinical nutrition, 2016-05, Vol.70 (5), p.607-612 |
| issn | 0954-3007 1476-5640 |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | 692/700/1518 692/700/228/491 692/700/2814 Aged Aged, 80 and over Arm Bioelectricity Classification Clinical Nutrition Cognition Cognitive ability Confidence intervals Electric Impedance Epidemiology Fat-free body mass Female Geriatric Assessment Grip strength Hand Strength Hospitalization Humans Impedance Internal Medicine Longitudinal Studies Male Malnutrition Malnutrition - diagnosis Malnutrition - etiology Malnutrition - physiopathology Medicine Medicine & Public Health Metabolic Diseases Nutrition Nutrition Assessment Nutritional Status original-article Patient admissions Patients Product/Service Evaluations Public Health Risk Factors Subacute care Subacute Care - statistics & numerical data Subgroups |
| title | How does nutritional state change during a subacute admission? Findings and implications for practice |
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